See if you are familiar with this scene: you arrive at the gym, stretch, starts your training program and soon starts to feel your shoulder joint, the same pain that has been with you for the latest weeks during certain exercises and some day by day situations. Therefore, you decide to stop training for some time. When you decide to come back, so does the pain and your performance is compromised, so you have to stop again. You´re not the only one. Many people who practice some sort of physical activity which demands strength from the upper body, specially from the shoulder joints, show some kind of lesion on the region for the instability of this particular articulation (due to its great flexibility), as well as for the lack of muscle strength, responsible for improving the stability of the shoulder (consequently, a strong shoulder), the ROTATOR CUFF. The shoulder joint is the most flexible of the human body for the wide range of motion required in the arms and hands, but this is the reason it is also so instable. Hence, all the muscles, ligaments and the capsule of shoulder joint have to be well synchronized and strong to its good function. When the joint capsule and glenohumeral ligaments (ligaments and joints inside the shoulder) are weak or damaged (dislocation, fracture, tendonitis, etc.), a muscle group called ROTATOR CUFF - responsible for maintaining the stability of the shoulder joints - tries to compensate the problem and, consequently, starts being more demanded on dynamic movements. That would not be a problem if those muscles were strong enough, but they rarely worked on conventional exercises at the gym. Repeated arm movements above the head cause the humerus (upper arm bone) to press against a part of the shoulder joint and its tendons, causing fibers laceration. If the individual continues movements despite the pain, tendon may lacerate or even rip out part of the bone. Shoulder pain is the main symptom. Initially, pain occurs only during activities that demand arm elevation above the head and back. After that, it develops to occur even on a simple gesture as shaking some body´s hand. That demand causes an extra charge on the muscles, which, if not strong enough to cope, pressure the Rotator Cuff tendons, causing tendons inflammation, making it aggravated and weak, which leads to pain. With the pain comes the incapacity to recover the total function of the shoulder, necessary to almost every sportive activities and day-by-day situations. In summary, every time you have a muscle in your body that is not strong enough to certain sports or day-by-day activities, the overcharge goes straight to ligaments, tendons and joints. In the specific case of the shoulder, in case you do not have a well balanced muscle structure and a strong Rotator Cuff, you will become acquainted with the famous tendonitis, bursitis, etc. LESIONS REASON Among the main reasons for shoulder lesions are: • Impact Syndrome: activities that demand repetitive movements from a specific joint end up generating lesions such as tendonitis, bursitis, etc. Some examples of such activities are tennis (servings and other above the head movements), volleyball (idem), swimming (crawl and butterfly stroke), judo (overcharge on the shoulder joint due to some strikes), playing an instrument (the position one plays the violin, for example), etc. • Unbalance and Instability of the Joint: as mentioned before, it is very important having muscles which play the opposite roll on the joint (biceps/triceps; quadriceps/ posterior; anterior fibers deltoid/ posterior fibers deltoid, etc.)proportionally worked for a balanced development which will cause stability during exercises and in postural aspects. • Wrong Execution and "Dangerous" exercises: try to avoid or ask your personal or gym trainer to modify the patterns of certain exercises that cause extra damage to the shoulder joints. Obs: a small variation on the exercises may cause significant diminish on joints overcharge. But remember: there are no unfit exercises, but people who are unfit to perform them. • Lack of warming up: the lack of a good warm up and stretching before weight lifting may cause serious lesions especially on cold days. As a suggestion, you could try a local warm up, that involves great muscle groups working with light weights and more repetitions then usual and doing some series before moving the joint about to be worked. • Bad posture: wrong posture during the exercises can cause the Rotator Cuff muscles to be overwhelmed and less efficient. It does not happen only due to lack of orientation during the exercise, but also from excessive charge - used specially by youngsters. It would not be a problem if it didn´t exceed their capacity, but in almost 100% of cases it does. • Recovering the lost time: that´s right! When physical activity is not a regular practice, one tends to increase weights and number of repetitions, forgetting that muscles adapt to training faster than tendons, ligaments and joints. In other words, muscles are prepared to increase weight, but other parts are not, which may cause lesions. Suggestion for training: As mentioned before, besides modifying or avoiding certain exercices, it is very important you do exercises to strengthen the Rotator Cuff, such as external rotation movements which can be made with rubber bands, weights or just body movement. Obs: internal rotation movements are not as important because they are already worked on regular exercises. Final tips: • If you feel pain, go see a doctor to find out the reason and do not exercise at all; • Ask your trainer to give you exercises to strengthen the Rotator Cuff. It does not take long and, even if you´re not in pain, it will help you prevent it; • Ask your trainer to replace certain exercises that may cause lesion for others that work the same muscles in a more safe way; • In case some other exercise makes you feel any pain, slight as it may be, do not hesitate in asking your trainer to replace it. Remember every lesion starts with a small pain; • And never forget: always stretch before you start weight lifting and warm up your muscles in exercises you´ll do with less weight befire actually beginning the series. See you next time!